Brief Report: Excluding the ADI-R Behavioral Domain Improves Diagnostic Agreement in Toddlers
Past research shows poor agreement between the Autism Diagnostic Interview-Revised (ADI-R) and other diagnostic measures in toddlers. Our goal was to examine whether exclusion of the ADI-R behavioral domain results in improved diagnostic agreement. Toddlers aged 16–37 months (M = 26 months) received an evaluation because they failed the Modified Checklist for Autism in Toddlers (n = 142). Evaluations included the ADI-R, Autism Diagnostic Observation Schedule, Childhood Autism Rating Scale, and clinical judgment. Results found poor to fair agreement between the ADI-R and other measures; agreement improved when the ADI-R behavioral domain was excluded. These findings suggest that stereotyped interests and behaviors are not as relevant to the ADI-R as other diagnostic criteria when evaluating toddlers for autism spectrum disorders.
KeywordsAssessment Diagnosis Toddlers ADI-R
This research was supported in-part by the University of Connecticut’s Research Foundation Faculty Grant, National Alliance of Autism Research, National Institute of Child Health and Human Development (5 R01 HD039961), Maternal and Child Health Bureau (R40 MC 00270). We are grateful to the children and families who participated in the study and our clinical and community collaborators for their continued support. We also thank the research teams at Georgia State University and the University of Connecticut for their dedication to the screening and early diagnosis study.
- American Psychiatric Association. (1994). Diagnostic and statistics manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
- De Bildt, A., Sytema, S., Katelaars, C., Kraijer, D., Mulder, E., Volkmar, F., & Minderaa, R. (2004). Interrelationship between Autism Diagnostic Observation Schedule-Generic, Autism Diagnostic Interview-Revised, and the Diagnostic and Statistical Manual of Mental Disorders Classification in Children and Adolescents with Mental Retardation. Journal of Autism, and Developmental Disorders, 34, 129–137.CrossRefGoogle Scholar
- Filipek, P., Accardo, P., Ashwal, S., Baranek, G., Cook, E., Dawson, G., Gordon, B., Gravel, J., Johnson, C., Kallen, R., Levy, S., Minshew, N., Ozonoff, S., Prizant, B., Rapin, I., Rogers, S., Stone, W., Teplin, S., Tuchman, R., & Volkmar, F. (2000). Practice parameter: Screening and diagnosis of autism. Neurology, 55, 468–477.PubMedGoogle Scholar
- Lord, C., & Richler, J. (2006). Early diagnosis of children with autism spectrum disorders. In T. Charman & W. Stone (Eds.), Social & communication development in Autism Spectrum Disorders: Early identification, diagnosis, & intervention (pp. 35–59). New York: Guilford Press.Google Scholar
- Lord, C., Rutter, M., DiLavore, P., & Risi, S. (1999). Autism diagnostic observation schedule—WPS edition. Los Angeles, CA: Western Psychological Services.Google Scholar
- Mullen, E. (1995). Mullen Scales of Early Learning. American Guidance Service.Google Scholar
- Risi, S., Lord, C., Gotham, K., Corsello, C., Chrysler, C., Szatmari, P., Cook, E., Leventhal, B., & Pickles, A. (2006). Combining information from multiple sources in the diagnosis of autism spectrum disorders. Journal of the American Academy of Child and Adolescent Psychiatry, 45, 1094–1103.PubMedCrossRefGoogle Scholar
- Robins, D., Fein, D., & Barton, M. (1999). The modified-checklist for autism in toddlers. Self-published.Google Scholar
- Schloper, E., Reichler, R. J., & Renner, B. R. (1988). The Childhood Autism Rating Scale. Los Angeles, CA: Western Psychological Services.Google Scholar
- Stone, W., Hoffman, E., Lewis, S., & Ousley, O. (1994). Early recognition of autism. Archives of Pediatric and Adolescent Medicine, 148, 174–179.Google Scholar